Weinzweig N, Jones N F, Shestak K C, Moon H K, Davies B W
Division of Plastic Surgery, University of Illinois at Chicago.
Ann Plast Surg. 1994 Oct;33(4):359-69; discussion 369-70. doi: 10.1097/00000637-199410000-00002.
The keel-shaped modification for harvest of the radial forearm osteocutaneous flap has been used to reconstruct 19 oromandibular defects in 18 patients. Fourteen men and 4 women ranging in age from 22 to 72 years have undergone composite mandibular reconstruction, with follow-up ranging from 3 to 36 months. Sixteen patients (17 reconstructions) had resection of advanced malignancies, and 2 patients sustained shotgun wounds. Twelve symphyseal and 7 lateral or posterior defects were reconstructed with donor radius bone ranging in length from 5 to 13.5 cm. Double osteotomies were performed in 7 patients. Two skin paddles were used in 4 patients to provide simultaneous intraoral lining and external skin coverage. The radial forearm osteocutaneous flap is still an excellent choice for oromandibular reconstruction. Anterior and lateral composite mandibular defects were satisfactorily reconstructed both aesthetically and functionally using the keel-shaped modification of the radial forearm flap. Donor-site problems were uncommon and minor, and long-term forearm function was minimally affected. Radius fracture occurred in only 1 patient.
用于切取桡骨前臂骨皮瓣的龙骨状改良方法已用于重建18例患者的19处口腔颌面部缺损。14名男性和4名女性，年龄在22至72岁之间，接受了下颌骨复合重建，随访时间为3至36个月。16例患者（17次重建）因晚期恶性肿瘤行切除术，2例患者遭受猎枪伤。12处下颌骨联合部缺损和7处外侧或后部缺损采用长度为5至13.5厘米的供体桡骨进行重建。7例患者进行了双截骨术。4例患者使用了两个皮瓣，以同时提供口内衬里和外部皮肤覆盖。桡骨前臂骨皮瓣仍然是口腔颌面部重建的极佳选择。使用桡骨前臂皮瓣的龙骨状改良方法，在美学和功能上均令人满意地重建了下颌骨前部和外侧复合缺损。供区问题少见且轻微，前臂长期功能受影响极小。仅1例患者发生桡骨骨折。
